Wednesday, May 23, 2012

Hospital Sunrises

Unfortunately, I watched the sunrise on Sunday and Monday mornings from a hospital window.  On Saturday night, Kevin was snuggling with Sam on the couch and he asked if I thought he sounded raspy at all.  I picked up him, held his chest up to my ear and it sounded clear as a bell.  He continued to sound fine all evening.  Besides the fact that it took Sam an hour and a half to finish his four ounce bottle, everything seemed perfectly fine.  However, at 2:00 a.m., Kevin bolted upright in bed, shook me awake  and said "listen!"  Sam's breathing sounded like he was struggling for his very last breath.  Every inhale sounded like something between a gasp and a bark, and every exhale sounded like he had three cups of mucous floating around his upper respiratory system.  I got him upright, and started clapping on his back pretty forcefully, half expecting him to just cough.  He wouldn't cough to save his soul.  He finally caught his breath, but his throat still sounded like it was full of gunk.  I warmed up some milk quick, thinking he could "rinse" it down.  After a half ounce, it was clear he wasn't going to get any better.  So, I packed him in the carseat, grabbed my breast pump, the diaper bag and hit the road.  Before I left the driveway, I got settled in with my pump, because let's face it - at 2:00 a.m. as a "pumping" mama, I was hurting!  (if it's illegal to pump and drive at the same time, let's not tell the officials please!)

I arrived at the hospital at 3:07 a.m.  Sam was seen almost immediately by the emergency department doctor on staff, and soon thereafter carted down to x-ray.  The x-ray showed no signs of pneumonia (phew).  So, we settled in to wait for the weekend on-call pediatrician to arrive.  We were admitted to the hospital, and transferred up to the pediatric department around 7:00, and seen by the pediatrician shortly after that.  (Of course it wasn't our regular pediatrician, but luckily this one is as wonderful!!)  Within in an hour, Sam had his nose swabbed for an RSV test, two small viles of blood drawn and an oximeter taped to his foot - all this after he was stripped naked from sleep to be weighed.  Oh by the way, he's finally gaining!  The pork chop weighed in at 10lb 2.2oz!

After giving him a thorough once-over, the doctor said "well, this is a puzzle."  It wasn't exactly what I was expecting to hear, but it was the truth.  He had no fever and no real signs of an infection as was determined by the CBC (complete blood count - no elevated white blood cells)  His tiny ear canals were clear and his throat was just right.  It came down to a common cold.

Sam was just coming down with a cold.  Really?  And we're in the hospital?  Great.

If you can picture his tiny pinky finger, that is how big the biggest main airway is in him, and everything that branches out from there is even smaller yet.  So you can imagine how little it would take for these airways to become restricted either by excess mucous or inflammation.  The doctor ordered nebulizer treatments with Albuterol, a drug that is supposed to help with wheezing and shortness of breath.  The lady who administered the neb treatment, also did BD's on Sam, whereby she used a small rubber ball/disk to "pound" the mucous out of his lungs.  He loved it!  She laid him this way and that way, right side up and upside down,  and pat pat patted away on his ribcage.  He was loving every minute of it, and the lady told me he was the best baby patient ever!  Sam also had three doses of Orapred, which is an oral steroid to help relieve his symptoms as well.

By 11:00,  I was starting to feel like a swamp monster, what with my unwashed hair, dirty clothes and dragon breath.  Luckily, a dear friend of mine lives just a few blocks from the hospital, and she happens to be Sam's godmother, so she was more than willing to come and sit with him while I ran to buy new underwear, a clean tshirt, a toothbrush, and run to her house to grab a quick shower.  By the time I got back to the hospital, I felt like a new woman!  Also by the time I got back to the hospital, I determined it would be wise to keep a bag with these essentials in it in the van at all times!

By 3:00 on Sunday afternoon, I was thinking things were looking pretty good.  But at 4:30, he started in again with the raspy breathing.  I was then told that the doctor wanted to keep him overnight for observation to make sure that his oxygen saturation levels didn't drop to an unsafe level.  So we settled in for the evening.  His sats stayed right around 94-96%, with an occasional dip to 88% - which was nothing to be real concerned with, as long as the dips didn't last more than a few seconds.

Around 8:00, I could barely keep my eyes open, and it was time for Sam to eat.  I was so exhausted, I really didn't have the oomph to pump and get a bottle ready for him.  So, even though we've only tried it a handful of times, we nursed.  We nursed!  Sam did it!  He latched on like a pro and went to town!  It was a wonderful moment for me as a mom, just because we struggled so much with nursing at the very beginning.  He was content, I was happy, life was good.  We tried again at bedtime, and though we struggled as much then as we ever had, I was ok with that.  The nurses were really encouraging me to keep trying, to stop pumping and strictly nurse.  Truth be told, pumping works for me - why fix something that isn't broken?  But it brings me gladness to know that he can do it, and we can do it when we want, on our terms.  We're in control of so little in the big picture, but this one thing we can control!

Sam was still awake at 10:00 p.m., but I laid him in the hospital crib, moved my pillows to the foot of the bed so I could see him during the night, and passed out.  I slept like a rock.  I'm not talking about the kind of rock you can kick around with your toes - I'm talking like-a-boulder-that's-planted-deep-in-the-ground-like-a-rock-sleep.  I didn't flinch until 6:00 on Monday morning.  Super mom.  I don't know if it was knowing that Sam was on monitors that would alarm if anything went awry, or if it was the fact that I had awesome nurses checking on him every hour, but I slept like I haven't slept since before any of my kids were born.

Monday morning, the pediatrician came to check on Sam around 9:00 and gave us the go ahead to head on home if we'd like.  Yes, we'd like.  But before he left, I asked him "is this going to happen every time Sam gets a cold?"  He explained that while some kids with Downs are born with heart issues, others are born with the inability to handle their secretions.  With his tiny airways, the smallest amount of mucous can cause problems.  We all have a cough reflex, but Sam's is slower and not as strong as ours, so he doesn't cough when he needs to, therefore the fluids collect and cause congestion.  He explained what is ok, and what is not ok, in terms of when to bring him in and when not to.  In other words, this will likely happen again down the road.

So we packed our bags and hit the road.  As scary as the whole experience was, I do know that it could have been so much worse.  We could have been at the hospital for major heart surgery.  While I can't help but think "this is what happens with 'just' a cold?", I also remind myself that we are lucky that Sam wasn't born with bigger problems.  And so, I bring our baby home once again, to take it one more day at a time.  Before I left home Sunday morning, I looked at Kevin and said "I have a feeling this is only the tip of the iceberg."  I see now that it likely is only the tip - I just hope and pray our ship is stronger than the Titanic.

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